A follow‐up study on respiratory outcomes, quality of life and performance perception of SARS‐CoV‐2 primary and reinfection in elite athletes: A 9‐month prospective study.

The prolonged consequences of SARS‐CoV‐2 on young elite athletes recovering from primary and reinfection are unclear. This study aimed to assess inspiratory/expiratory muscle strength and respiratory function at the time of spontaneous recovery at 3, 6, and 9 months after SARS‐CoV‐2 primary and reinfection in elite athletes. The study enrolled 25 elite male judoists, including 11 primary infection cases, five reinfection cases, and nine controls from the Türkiye Olympic Preparation Center. Inspiratory/expiratory muscle strength and respiratory function were measured, including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and peak expiratory flow (PEF) before and up to 9 months after SARS‐CoV‐2 infection in the early pre‐competition preparation phases. The most common symptoms reported by reinfection cases were fatigue (80%), dyspnea (60%), and muscle/joint pain (60%), while primary infection cases reported fatigue (73%), muscle/joint pain (45%), and headache (45%). MIP decreased by −14% and MEP decreased by −13% following the SARS‐CoV‐2 infection in reinfection cases. Likewise, FEV1 and FVC decreased by −5% and −8%, respectively; consequently, FEV1/FVC increased by 3%. Inspiratory/expiratory muscle strength and respiratory function improved rapidly after 9 months of SARS‐CoV‐2 infection in primary cases, whereas dysfunction persisted in reinfection cases. PEF was unaffected throughout the 9‐month follow‐up period. Reinfection may lead to further alterations in respiratory system relative to the primary infection, with a suspected restrictive pattern that remains dysfunctional in the third month; however, it improves significantly during a 9‐month follow‐up period. Highlights: In elite judo athletes, reinfection with SARS‐CoV‐2 cause more severe respiratory dysfunction compared to primary infection, with notable impairments in maximal inspiratory pressure (MIP) and MEP by −14% and −13%, respectively, at 3 months.FEV1 and FVC decreased by −5% and −8%, respectively, at 3 months post‐infection. Although respiratory function gradually improved over 9 months, some reinfected athletes have the potential to exhibit a suspected restrictive abnormality (FVC <80% of predicted) characterized by a greater decrease in FVC compared to FEV1, leading to an increased FEV1/FVC ratio.Reinfected athletes who have recovered from SARS‐CoV‐2 infection may require a longer recovery period before returning to training and competition. It seems warranted that they should be followed carefully in terms of clinical rehabilitation needs after a repeated infection and directed to specific care pathways aimed at reducing long‐term adverse effects. [ABSTRACT FROM AUTHOR]